HomeMy WebLinkAbout0017462-Plumbing (laterals) CITY OF OSHKOSH N° 17462
PERMIT - APPLICATION AND RECORD
TYPE: BLDG ❑ HTG ❑ ELEC ❑ PLBG 52, SIGN ❑ ZONING FLOOD PLAIN HEIGHT
ADDRESS 140 5 / C _ L!?it� c PLAN NO.
OWNER �� f `� ,
DESIGNER
USE /NATURE OF WORK -� ____ ��. ---zz 7,
BUILDING CONTRACTOR
Size Sq. Ft. # Rooms # Stories Height
Foundation Class of Const. Occupancy Permit
HEATING CONTRACTOR
Heat ❑ A/C ❑ Vent ❑ Fuel /System Heat Loss BTU'S
ELECTRIC CONTRACTOR
Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps
Fixtures Switches Receptacles Circuits
PLUMBING CONTRACTOR i i 7 Z
BT WH Disp WSoft CBasin
Lay Sh DW DF 2_ San. Sewer /
WC FDr SP Ur Storm Sewer
Sink LTub Eject SS Water / 9
Other OO
FEES: Valuation $ ?CV v Permit Fee Paid $ / Park Dedication $
ISSUED BY -.X.--.._ Date ,5 7 Final /O.P.
In the performance of this work I agree to perform all work pursuant to rules governing the described construction.
SIGNATURE /f i.r.,A`.� �� d' 3, - ._ C ' 9 "
AGENT /OWNER !! DATE
ADDRESS
TELEPHONE #
/ PLUMBING PERMIT APPLICATION f r
ADDRESS // 4 J/ Cf_�IA si f r✓ /U DATE / //, /0 PERMIT # /7 ‘L—
OWNER PLUMBER 1p.rr g
NATURE OF WORK CCU''✓ (A e' --ti" ( S�"/ °/�) 7
NEW RELAY REPAIR INTERIOR
SAN SEW y 1 lfr ' ��
WATER Bathtub Catch Basin
STORM SEW Lavatory Grease Trap
Toilet Sump Pump
INSPECTION DATE INSPECTION DATE Kit Sink Local Waste
Sink(other) Site Drain
C "/ f �- b ( - " Shower Laundry Stand pipe
C(rtI Floor Drain Laundry Tray
Disposal Wat. Softner
Dishwasher D. Fountain
Water Heater Ejector'
1 Urinals Future outlets
** Violation notes on reverse side